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As The Hospital Pervs

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It doesn't feel like I slept an extra hour, but I am sure the night shift feels like they worked an extra hour.
 
The bad news is: I have high levels of IgG, and IgM to Lyme. I have spent many summers in the mountains, and this spring I had a tick on me. I never had a rash, and I never felt acutely sick. I don't remember being sick.

There is much controversy about Lyme Disease.

The good news is that I don't have syphilis.

Why was I even tested? I thought I was crazy, and it is a part of the psychiatric blood work up, because both of these germs can affect the brain.

I discussed this with my friend the infectious disease specialist at work.

Me: I thought I was crazy, and this blood work came back.
He: You are still crazy and that has nothing to do with the tick. I will look at the results, get me the numbers. (and stop reading about Lyme.) :heart:
 
Still DTing but managing with every 1 hour Ativan.
The goal is to prevent the tube.
It's exhausting work.

Yesterday I skipped 1 hour and it took me 3 hours to catch up.
 
There's no transfer out of ICU till CIWA is less than 10 for at least 4 hours.
It's never been less than 10 yet.
 
I saw where the CDC is recommending testing for Hepatitis C for everyone born between 1945 & 1965.

Which includes me.

Why?

I go in for my annual checkup next week, thought it might be good to know something about it.

And thought you guys could give me the highlights from a practical viewpoint. I don't even know how Hep C is different from the others.
 
I worked the night shift on time change and wanted to rip my eyes out from boredom. They also picked that night for computer downtime during the time change so that wasn't confusing at all.

CIWA....precedex and Ativan liberally. Although I was always amused by the hallucinations.
 
Happy Monday. I trust everyone survived time-change weekend nicely enough.


I'm back to feeling really awake by oh five thirty now. :rolleyes:
 
Balladeer08 said:
ALL your hair?
Click to expand...
I did it in two phases: first to the shoulder, but that wasn't enough for me. I went back a few weeks later and cut up to my ears. I am not happy with the layers she put in the back. I have always had all one length hair most of my life. It's just hair and it grows back.

There's still enough to grab.
 
GoddessTink said:
I worked the night shift on time change and wanted to rip my eyes out from boredom. They also picked that night for computer downtime during the time change so that wasn't confusing at all.

CIWA....precedex and Ativan liberally. Although I was always amused by the hallucinations.
Click to expand...
I can't imagine working a night shift. I know they get busy sometimes, especially when there are open beds and they start filling up. I wish they could walk a dayshift shoe every once in a while. It's almost like they have no compassion for day shifters--you know going through six pages of new orders in 12 hours, carrying out all those interventions, replacing lytes, antibiotics, stat mediations, stat labs, rounding, weaning, extubating and on, and on.

The fifty five questions they have at shift change, and then the next day I see half of them finishing their homework for advanced degrees, sitting at the desk.

Oh well, they deserve to sit down. I wouldn't want to stay up all night.
---

I forgot about the precedex! This DTer is the sweetest one so far, not combative (yet), and the Ativan every one hour was working. I missed a few times because he looked calm and then I had to play catch up with extra dosing. It's day 4 now, and when I left last night he was getting more delirious. It's hard work trying to prevent the tube. I hope I don't walk in today to an intubated patient. It just causes complications-- but sometimes you have to.

This isn't his first time at the rodeo, but I looked back at the history and he was only intubated once before for withdrawal. He might get out of the weeds.
 
In other breaking news: this day three is going to exhaust me. It's not so bad on weekends, but Monday morning is always rough. I am going into the DTer and an open bed with RRT/Code nurse job.
 
I did days and nights. Days are way busier than nights ever wanted to be. But nights ends up with trainwrecks with none of the departments you need in house to help out and even fewer doctors.

It's bad both on days and nights just depending on your patients and how sick they are.
 
Balladeer08 said:
I saw where the CDC is recommending testing for Hepatitis C for everyone born between 1945 & 1965.

Which includes me.

Why?

I go in for my annual checkup next week, thought it might be good to know something about it.

And thought you guys could give me the highlights from a practical viewpoint. I don't even know how Hep C is different from the others.
Click to expand...
I wrote a long essay about Hepatitis C Virus (HCV), but I saved it and I will go with the short answer.

My best guess for the specific years is related to infection control practice, blood product administration prior to screening, and possibly tattoos. The sexual transmitted route between monogamous relations is very low, with the exception of sex in the ass, or sex during menses. The most common route of transmission is blood to blood via intravenous street drug usage.

Another rationale may be that there are newer treatments with less side effects, so why not seek treatment?

The most practical reason may be that the this chronic infection can cause problems later in life: liver failure, cirrhosis, liver cancer. And there may be no early symptoms at all.

The treatment is individualized, there are many people who have antibodies (exposure) to HCV but have no viral load at all, and there are some people who spontaneously clear the viral infection on their own.
--
HAV: is transmitted via poop, drinking contaminated water, or utensils. It's an acute infection, it doesn't become chronic. It's resolvable. Vaccine is available.

HBC: Is via body fluids, much like HCV and can become chronic, after an acute illness. It's mostly resolvable. Vaccine is available.

HCV: Is via blood to blood mostly. There may not be any acute phase and it can be chronic without any symptoms till later in life. Vaccine is not available.
--

It's not a bad idea to be tested, but know that there are many false positives with the initial lab test and this leads to additional blood testing.

And if a person does test positive: liver precautions-- no booze.

Many people with HCV die from other illness before the HCV kills them. I am not diminishing the virus, but just making a point.
---

The people I see sick from HCV are alcoholics, because not only do they have alcoholic liver failure they have HCV on top of that.
 
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